保健医療科学

2019Vol.68 No.4 p.334－342

特集：健康先進国に求められる文化に即した保健医療―災害保健活動に焦点を当てて―＜ Review ＞
Providing culturally safe nursing care in disaster:
Japanese and New Zealand perspectives
Lev Zhuravsky 1), Nahoko Harada 2)
1)

Lazer Consulting. Auckland, New Zealand2)

Department of Psychiatric and Mental Health Nursing, School of Nursing, Faculty of Medicine, University of Miyazaki

Abstract
The purpose of this review is to introduce a concept of a culturally sensitive approach to the disastermanagement and response by providing specific examples from two major natural disasters in Japan and
New Zealand.
This review also provides a brief outline of national and local disaster management structure, drawing
from extensive experience accumulated in both countries.
Consequently, this review introduces a concept of cultural safety and expands its reach in the context ofproviding a culturally sensitive response in Great East Japan Earthquake disaster and Christchurch earthquakes 2011.
This review also expands a link between culturally sensitive response and community resilience.
keywords: Disaster, nursing, resilience, community, cultural safety(accepted for publication, 31st July 2019)

I．Introduction
The Asia-Pacific region is the most disaster-prone area of
the world and it is also the most seriously affected one. Almost 2 million people were killed in disasters between1970
and 2011, representing 75 per cent of all disaster fatalities
globally [1]. Both Japan and New Zealand situated in the
Pacific ring of fire area which increases their risk and exposure to devastating earthquakes. Great East Japan earthquake disaster and Christchurch earthquakes 2011 posed
unique challenges for the affected communities.
The aim of this review is to describe disaster landscapesin Japan and New Zealand and to outline disaster management approaches for both countries, focussing on cultural
aspects of disaster response and recovery.
This review introduces a concept of cultural safety innursing care and pays particular attention to the role ofculturally safe nursing care, providing the examples fromJapan and New Zealand experience. Addressing cultural

aspects during a disaster response and recovery phases canpromote community resilience and assist in building an additional capacity.
The link between culturally safety and disaster nursing
response requires further research and exploration. However, it provides an important insight and learning point about
the importance of integration of cultural competencies into
the overall disaster response and health care system response in particular.

II．Disaster landscape and cultural implications: New Zealand
New Zealand is exposed to a range of significant hazards and threats. Natural hazards, such as earthquakes,
volcanoes, or extreme weather, are only one type. New
Zealand economy relies heavily on primary production andis vulnerable to adverse impacts from pests and diseases;
the potential for an infectious disease pandemic has been

Corresponding author: Lev Zhuravsky
E-mail: connect@lazer.org.nz

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Providing culturally safe nursing care in disaster: Japanese and New Zealand perspectives
highlighted in recent years through the bird and swine flu
crises; heavy reliance on technology and just-in-time supply
chains means we are vulnerable to disruption from a wide
range of domestic and international sources; and the global
geopolitical environment means threats to our security andeconomy are complex and often unpredictable. In New Zealand, risks are classified into five categories: natural hazard
risks, biological hazard risks, technological risks, security
risks, and economic risks [2].
Aotearoa New Zealand is officially a bicultural nation,and is governed by a bicultural legislative foundation. The
two predominant cultural groups are Māori and New Zealand Pākehā (people of European origin). New Zealand has
three official languages: Te Reo (Māori language), English,
and New Zealand Sign Language. Aotearoa New Zealand isbecoming increasingly multicultural so there are increasing
numbers of people who identify with other cultures anduse languages other than Te Reo or English as their first
language. Following the Canterbury earthquakes, central
and local government acknowledged that they needed to
improve how they engaged with culturally and linguisticallydiverse (CALD) communities when carrying out emergency management [3].
The effective response and significant community support facilitated by Māori in the aftermath of the Canterbury
earthquakes, as well as in other emergencies, has generated considerable interest in Māori disaster resilience. Māorimoral and relational attributes applied to create community
resilience promote a collaborative approach to disaster
response and recovery, commitment to environmental
restoration, and the extension of hospitality to others experiencing adversity. Māori also has assets and places, which
often have, and will again be mobilized to secure community wellbeing in the aftermath of disasters [2].

III．Disaster landscape and cultural implications: Japan
Japan, as a part of the ring of fire, experienced uncountable tectonic activity related to natural disasters, including earthquake, tsunami, volcanic eruption, pyroclastic
flow, and ashfall. Also, Japan experienced a chemical terrorist attack in 1995 and the nuclear disaster in 2011. There isno case identified in Japan with infectious diseases which
the Public Health Emergency of International Concern
determined its risk. Disasters equally affect people despite
their nationality, race, or ethnicity.
The number of foreigner in Japan has increased over theyears, and the record indicates 2,730,093 residents in 2018[4] which is more than two percent of total population [5].
These people came from 195 countries or area of the globe,

and more than half proportion of these come from China(28.0%), Korea (16.5%), and Vietnam (12.1%) [6]. The
number of foreign visitors is 28,691,073 in 2017, and Korea,
China, and Taiwan are the top three countries[7]. People
living in a country where the language is not the same astheir first languages are considered vulnerable population
under disasters. Ito reported higher death rate in foreigners
compares to Japanese at the Hanshin Awaji earthquake in1995 and surveyed newsletter addressing foreign affected
people [8]. She reported that foreigners lived in old houses,
and they were overstayers afraid of deportation, besides
language difficulties and no health insurance. This indicatesinequity in disaster risk reduction and response for people
whose first language is not Japanese.
The official language of the country is Japanese, and English has used for foreigners. The languages used by the
majority of foreigner in Japan, and visitors do not match thelanguage used for information sharing in general. Kanbara
et al. identified through analysing disaster and emergency
relief information at stations, sightseeing spots and educational institutions [9,10]. Information identified was inEnglish and hard to read because of location or litter size.
Although the Council of Local Authorities for International
Relations developed a multilingual disaster information tool
which online system translates the disaster-related term
into seven languages [11], this tool needs more attention toreach more people whose first language is not Japanese.

IV．National and local disaster management
approach: New Zealand1．New Zealand National Disaster Resilience Strategy
Civil Defence Emergency Management (CDEM) in New
Zealand is governed by the CDEM Act 2002 which (a)promotes the sustainable management of hazards in a waythat contributes to safety and wellbeing, (b) encourages
wide participation, including communities, in the process
to manage risk, (c) provides for planning and preparationfor emergencies, and for response and recovery (d) requires local authorities to co-ordinate reduction, readiness,
response and recovery activities through regional groups,(e) provides a basis for the integration of national and local
planning and activity through a national strategy and plan,(f) encourages coordination across a wide range of agencies,
recognising that emergencies are multi-agency events affecting all parts of society [12]In 2019 the Ministry of Civil Defence and Emergency
Management has published a comprehensive National Civil
Defence Emergency Strategy, aiming to set out goals andobjectives for civil defence emergency management overthe next ten years. This Strategy has been given the name

J. Natl. Inst. Public Health, 68 (4) : 2019335

Lev Zhuravsky, Nahoko Harada
of National Disaster Resilience Strategy to reflect the factthat one of the main goals of this Strategy was a development of capabilities to respond to disaster focussing on
building community resilience.
Disaster resilience is the ability of individuals, communities, organizations, and states to adapt to and recover fromhazards, shocks, or stresses without compromising longterm prospects for development. According to the Hyogo
Framework for Action [13], disaster resilience is determined by the degree to which individuals, communities andpublic and private organizations are capable of organizingthemselves to learn from past disasters and reduce theirrisks to future ones, at international, regional, national andlocal levels.
Of a particular note, it should be pointed out that this National Strategy emphasizes the link between culture of communities and the resilience, by recognizing the importanceof culture to resilience, including to support the continuityof cultural places, institutions, and activities, and to enable
the participation of different cultures in resilience. This
Strategy clearly states that how culture sustains us in times
of upheaval is a key area for consideration for communities
and emergency management organizations alike. Culturallife, including cultural practices and events, institutions,heritage buildings, and cultural practices are important to
our wellbeing, and for maintaining a sense of normality andcomfort during and following emergencies. We must dowhat we can to ensure the continuity of cultural life [2].
2．New Zealand National Civil Defence Emergency
Management Plan
The National Civil Defence Emergency Management
Plan 2015 sets out the roles and responsibilities of everyone
involved in reducing risks and preparing for, responding to,
and recovering from emergencies. This includes central andlocal government, lifeline utilities, emergency services, andnon-government organizations. This plan clearly identifies
four key components in the emergency management process, which are also known as 4 Rs (Table 1). The purposeof this plan is to state the guiding principles and roles andresponsibilities for CDEM across the 4 Rs at the national
Table 1level so that all agencies and CDEM Groups are able to (a)understand the hazards and risks; (b) work to reduce thosehazards; (c) build resilience in respect of those hazards;and (d) build capability and capacity to provide coordinated,
integrated, and effective responses to, and recovery from,emergencies [14].
Following guiding principles of this plan, the New Zealand
Ministry of Health developed the National Health Emergency Plan. The plan builds on the experiences of preparing for,building resilience to, responding to and recovering from a
range of hazards in New Zealand and elsewhere, including
human disease pandemics, tsunami, terrorist incidents,
earthquakes, and technological incidents over the past decade. The plan recognizes that supporting individuals, families, and communities in preparing for, responding to andrecovering from emergencies requires effective planning
based on an understanding of community vulnerabilities,risks, and strengths [15].
The plan clearly states that communities should be
actively involved in all aspects of resilience-building andpreparedness planning, implementation, and review. It is
important to: understand that communities are made up of
dynamic and networked groups of people engage with communities proactively and meaningfully support and build on
networks and activities that already exist within communities. Ensure that emergency health and welfare services address the specific needs of communities enhance self-reliance for all individuals, families, and groups in communities[15].

V．National and local disaster management
approach: Japan
Three laws, Disaster Measures Basic Act, Disaster Relief Law, and Act Concerning Support for Reconstructing
Livelihoods of Disaster Victims aim to protect people in allphases of disaster. The Disaster Measures Basic Act focuses on prevention, mitigation, and disaster risk reduction.
The Disaster Relief Law aims to protect affect populationand social orders by providing 12 areas of relief work during
the early phases of disaster; removing road blockage, res4Rs

Reduction Identifying and analysing risks to life and property from hazards, taking steps to eliminate those risks if practicable, and, if not,reducing the magnitude of their impact and the likelihood of their occurrence to an acceptable level.
Readiness Developing operational systems and capabilities before an emergency happens, including self-help and response programmes
for the general public and specific programmes for emergency services, lifeline utilities, and other agencies.
Response

Actions taken immediately before, during, or directly after an emergency to save lives and property, and to help communities
recover.

Recovery

The co-ordinated efforts and processes used to bring about the immediate, medium-term, and long-term holistic regenerationand enhancement of a community following an emergency.

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Providing culturally safe nursing care in disaster: Japanese and New Zealand perspectives
cue, missing body searching, burial, medical care, shelter
and temporary housing, food, water, non-food items, temporary housing repair, financial support, and school supplies.
The Act Concerning Support for Reconstructing Livelihoods of Disaster Victims provides affected people grants
to reconstruct livelihoods.
Regarding medical relief, the Red Cross has been ahumanitarian worker under the Japanese Red Cross Law
enacted in 1952 [16]. The Disaster Medical AssistanceTeam was established in 2005 by the Ministry of Health,
Labor, and Welfare from the lessons learned from the Hanshin-Awaji earthquake in 1995 [17]. Since then, the Disaster
Psychiatric Assistance Team and the Disaster Health Emergency Assistance Team have established in 2013 and 2016,
respectively [18, 19]. The Japan Medical Association formed
the Japan Medical Association Team in 2011 soon after theGreat East Japan Earthquake disaster onset [20]. Besides
these relatively formal organizations, there are numbers of
Non-Governmental Organizations and Non-Profit Organizations being a part of disaster medical relief, and the numbers are growing.
After the Kumamoto earthquake disaster in 2016, coordination among medical assistance teams has been a focus
to be strengthened to provide more comprehensive healthservices for people, including vulnerable population [21].
However, linguistical and culturally competent care for foreigners is challenging even during the non-disaster phase.
Namikawa and colleagues investigated 327 cities, townships, and villages about preparedness of disaster responsemanuals in 2013 [22]. The study reports 80% of participants
need the manuals whereas less than 1% has created manuals. This study indicates a need for disaster risk reduction
strategies and practice suitable for people whose first language is not Japanese.

VI．Cultural safety and nursing practice in
New ZealandNursing Council of New Zealand defines cultural safety
as the effective nursing practice of a person or family fromanother culture and is determined by that person or family.
Culture includes, but is not restricted to, age or generation;
gender; sexual orientation; occupation and socioeconomic
status; ethnic origin or migrant experience; religious or
spiritual belief; and disability. The nurse delivering thenursing service will have undertaken a process of reflection
on his or her own cultural identity and will recognise theimpact that his or her personal culture has on his or her
professional practice. Unsafe cultural practice comprises
any action which diminishes, demeans or disempowers thecultural identity and well- being of an individual.

Cultural safety relates to the experience of the recipientof nursing service and extends beyond cultural awarenessand cultural sensitivity. It provides consumers of nursing
services with the power to comment on practices and contribute to the achievement of positive health outcomes andexperiences. It also enables them to participate in changing
any negatively perceived or experienced service [23]. A key
concept of cultural safety implies that to be culturally safe
in any situation you first need to understand your own culture and feel connected to it.
Four main principles are central to cultural safety. Principle one focuses on improving the health status of New
Zealanders and emphasizes health gains and positive healthoutcomes. In addition, it requires that nurses acknowledge
the beliefs and practices of those who differ from themthrough age or generation, gender, sexual orientation,
occupation and socioeconomic status, ethnic origin or migrant experience, religious or spiritual belief and disability.
Principle two focuses on a culturally safe nursing workforce
by emphasizing the significance of power relationships
and the need for nurses to undertake a careful process ofinstitutional and personal analysis of power relationships.
Principle three requires a broad application of culturalsafety to encompass recognizing inequalities within healthcare interactions that are reflective of historical and social
inequalities in health. Finally, principle four states that
cultural safety has a close focus on the nurse as a bearer ofhis/her own culture, history, attitudes, and life experiences and the response other people make to these factors.
It challenges nurses to examine their practice carefully;
recognizing that the power relationship in nursing is biased
toward service providers and that there is a need to balance
power relationships in practice, so consumers receive aneffective service. Cultural safety also includes an emphasis
on preparing nurses to resolve any tension between thecultures of nursing and the people using services so as toprovide equitable, effective, efficient and acceptable service
delivery, which minimizes risk to people [23].

VII．Cultural safety and nursing practice inJapan
Cultural safety has not been widely recognized in Japandespite increasing numbers of foreign residents and visitors. In nursing education, cultural considerations utilizing
theories proposed by McFarland and Wehbe-Alamah[24],Giger and Davidhizar and Giger[25], and Purnell [26] are
discussed in global health and context which may imply
nurses should be aware of importance of cultural competency when they work in foreign countries or for international
non-governmental organizations rather than caring foreign

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Lev Zhuravsky, Nahoko Harada
people seeking help in Japan. However, literature indicatessubstantial gaps to be filled for health services for people
whose first language is not Japanese. Several articles indicate that difficulty in communication is a major barrier
accessing to health services for people whose first language
is not Japanese [27-31]. This type of report persistently
appears over and over and this implies insufficient healthservice system still exist in Japan.

VIII．Cultural aspects of community resilience
Community resilience can be defined as the capability
to anticipate risk, limit impact, and bounce back rapidly
through survival, adaptability, evolution, and growth in theface of turbulent change [32]. A cultural turn has been identified within disaster research in recent years due to theincreased attention to how culture mediates disasters andexacerbates or mitigates their impact [33]. By shifting the
focus from short-term disaster management to longer-term
disaster risk management in the Sendai Framework for
Disaster Risk Reduction (DRR) 2015–2030 greater space isprovided for wider structural determinants of vulnerability,
including cultural considerations [34].
Culture is an ever-changing process, as the adaptation
practices, both visible and intangible, conducted for millennia by populations prone to disasters have proved [35].
People tend to adapt actively and creatively to contain risks
affecting the areas in which they are accustomed to live because of the repetitiveness and the predictability of certain
hazards. The recurrence of risk can be an important driverof both destructive and positively transformative culturalchange in the areas of politics, economics and society [36].
Supporting cultural values and addressing social and economic factors during a recovery phase could promote self
-efficacy and contribute to the development of the resilient
communities.

IX．Cultural aspects of nursing care in disasters
1．Christchurch, New Zealand Earthquakes
In 2010 and 2011, the Canterbury region of New Zealand
was hit by a number of significant earthquakes. The firstearthquake, on September 4, 2010, was of Magnitude (Mw)
7.1 and resulted in numerous injuries and significant infrastructure, land, and building impact. There was no loss oflife, but many people were displaced from their homes, anda local State of Emergency was declared. A second major
earthquake which hit the city of Christchurch, on February 22, 2011, was of the lower magnitude of Mw 6.3 but

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resulted in significant loss of life: one hundred and eightyfive people died as a direct result of the earthquake andthousands were injured . This was the second deadliest
natural disaster in New Zealand history. A national State ofEmergency was declared and remained in effect until April
30, 2011 [37]. By March 2016, greater Christchurch had
experienced almost 18,000 aftershocks; over 35 of thesewere of magnitude 5 Mw or greater [38].
The loss of lives and impact on communities and livelihoods had severe implications for the health and wellbeingof individuals in the affected areas and required collaborative action to support psychosocial recovery [37]. The
eastern side of Christchurch, an area that was primarily
comprised of communities with limited socioeconomic resources, was the region most significantly impacted by theearthquakes. The geospatial concentration of Māori in theseverely impacted areas suggested that in comparison withthe wider community, Māori were disproportionately affected in terms of reduced financial resources, access to basic
necessities, sanitation, power, transport, and support fromfrontline responders [39].
It is expected that nurses, like other health professionals,
will play a significant role following a disaster. Indeed, nurses have been active participants in response and recovery
efforts during and following disasters [40]. The nursing
response following the February 22 earthquake has notdiffered from described in the previous research. Nurses on
duty cared for patients in whatever way they could, and thisincluded working in the hospital emergency department,
evacuating wards, assessing conditions in residential homes
and working in the community.
Disaster professionals, health care providers, and persons affected and impacted by disasters all bring individual
learned patterns of language and culture to any experience.
These unique patterns must be transcended in order toachieve equal access, reduce the loss of lives and property,
and improve the quality of health care provided. Disaster
professionals do not have to be students of sociology oranthropology in order to understand and appreciate culturaldifferences and better relate to the varied neighborhoods
within which they work. Relief during a disaster, by its very
nature, is more immediate, and the principal responsibilityof a first responder is to take action, not change beliefs. In
either case, it is important to know the culture of the community affected, for you cannot change long-held beliefs if
you do not understand those beliefs, and you cannot expect
people to take action contrary to their common sense if you
do not understand what motivates them [41].
In the immediate response and more prolonged recovery
phases, following the Christchurch earthquakes, nursing
teams in both acute care settings and the community have

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Providing culturally safe nursing care in disaster: Japanese and New Zealand perspectives
based their care on main principles of culturally safe nursing as outlined in the previous section of this review. There
were mindful and aware of their own culture and beliefs
while providing care to patients in hospitals and community.
Interactions with patients took into account multiple factors
to ensure patients and their families felt supported, listened
to and empowered. In many cases patients and people impacted by the earthquake had an opportunity to express
what felt right to them in all concerning nursing care. It
assisted in building their sense of power and independence
and also helped to cope with ongoing stress and anxiety
during many months of ongoing aftershocks which followed
the February 22 earthquake.
The link between culturally safety and disaster nursing
response requires further research and exploration. However, it provides an important insight and learning point about
the importance of integration of cultural competencies into
the overall disaster response and health care system response in particular.
2．Japan: Great East Japan Earthquake Disaster
On March 11, 2011, the Great East Japan Earthquake
disaster occurred and resulted in 19,689 death toll and 2563
missing as of 2019 March. Literature search with key wards
including disaster, culture, nursing, and care in English andJapanese was attempted with the search system named“Ichushi-Web”. None article addressing cultural safety at thetime of disasters was identified. However, Foster and Hirata
reported results from questioner survey for 154 foreigners
who resided in Tohoku area; Iwate, Miyagi and Fukushima
and were affected by the Great East Japan Earthquake Disaster [42]. The participants reported less stress-related
symptoms if they had many Japanese friends and felt senseof belonging to the society, however this study did not
mention whether these residents received culturally safe
support or care. There was a positive correlation between
sense of belonging and the number of friends which may
suggest these participants held high fluency in Japanese orfriends spoke fluent English. The paucity of culturally competent care urgently calls for knowledge, good practices, aswell as research in this area in Japan where more inboundand immigrant and/or migrant population is expected because of the Olympic and Paralympic games in 2020 andEconomic Partnership Agreement. Nurses are expected tocope and adapt to rapidly changing society even or certainly
in disaster context [43].

X．Conclusion
This article addressed differences and similarities ofdisaster risk reduction and response mechanisms in two

Pacific rim countries. Both countries have developed structured and organized national and local systems. However,
New Zealand have thrived to incorporate Maoriʼs culture
into disaster risk reduction and response mechanisms
whereas systems of Japan seem to be built on homogeneous
culture and its language, Japanese. Two earthquake disasters occurred in 2011 in each country depict there are gaps
about sufficient and culturally competent support for venerable population. This paper also introduced cultural safety
which is now required training for all nursing professions
in New Zealand. Providing culturally safe care would beachieved through self-awareness of own culture and whether it is achieved will be judged by clients not care providers.
Evaluation research for cultural safe training would be afoundation for sound disaster risk reduction as well as goodpractices and further evidence for disaster response.

Acknowledgments
This work was supported by JSPS KAKENHI Grant
Number JP17H04470.

References[1] ESCAP. Asia Pacific Disaster Report.2012. https://www.unescap.org/publications/asia-pacific-disaster-report-2012-reducing-vulnerability-and-exposure-disasters (accessed 2019-07-29)[2] New Zealand Ministry of Civil Defence and Emergency
Management. National Disaster Resilience Strategy.
2019. https://www.civildefence.govt.nz/cdem-sector/
plans-and-strategies/national-disaster-resilience-strategy/ (accessed 2019-07-24)[3] New Zealand Ministry of Civil Defence and Emergency
Management. Including Culturally and Linguistically Diverse (CALD) communities.2013. https://www.
civildefence.govt.nz/assets/Uploads/publications/is-12-13-including-cald-communities.pdf (accessed
2019-07-30)[4] Ministry of Justice. The number of foreign residents
as of the end of March 2019. http://www.moj.go.jp/
nyuukokukanri/kouhou/nyuukokukanri04_00081.html(accessed 2019-07-30) (in Japanese)
法務省．平成30年末現在における在留外国人数に
つ い て．2019．http://www.moj.go.jp/nyuukokukanri/kouhou/nyuukokukanri04_00081.html (accessed 201907-30)[5] Reshad K, Maesato K. The health and social situationof the foreigners loving in Japan. Journal of International Health. 2008;23(1):15-17. (in Japanese)
レシャードカレッド，前里和夫．在日外国人の保健

J. Natl. Inst. Public Health, 68 (4) : 2019339

Lev Zhuravsky, Nahoko Harada
医療―問題と対策．国際保健医療．2008;23(1):15-17.
[6] Japan National Tourism Organization. Visitor Arrivals,
Japanese Overseas Travelers. https://www.jnto.go.jp/
jpn/statistics/marketingdata_outbound.pdf (accessed
2019-07-30) (in Japanese)
日本政府観光局．年別訪日外客数，出国日本人数の推 移．https://www.jnto.go.jp/jpn/statistics/marketingdata_outbound.pdf (accessed 2019-07-30)[7] Japan National Tourism Organization. The numberof visitor arrivals sorted by nationality and purposein 2017. https://www.jnto.go.jp/jpn/statistics/tourists_2017df.pdf (accessed 2019-7-30) (in Japanese)
日本政府観光局．2017年に国籍と目的によりソートさ れ た 訪 問 者 の 到 着 数．https://www.jnto.go.jp/jpn/
statistics/tourists_2017df.pdf (accessed 2019-7-30)[8] Ito T. Features of foreign victims and support provided
to them after the Hanshin-Awaji earthquake. Journal ofInternational Health. 2009;24(3):257.
[9] Kanbara S, Nagasawa K, Go S. Barriers to disastermedical information dissemination in multicultural society. Journal of International Health. 2014;29(3):219.
[10] Kanbara S, Lee HY, Ngatu RN, Nojima S, Nagasawa K,
Yamada S. Shortfall of disaster health information forforeign residents in Japan. Health Science International. 2016;10(2)1-5.
[11] Council of Local Authorities for International Relations.
Multilingual information generator tool for disasters,
revised version. http://www.clair.or.jp/j/multiculture/tagengo/tool.html (accessed 2019-07-30) (in Japanese)
自治体国際化協会．多文化共生―多言語情報等共通ツールの提供―．http://www.clair.or.jp/j/multiculture/tagengo/tool.html (accessed 2019-07-30)[12] New Zealand Parliamentary Counsel Office. Civil
Defence Emergency Management Act. 2002. http://
www.legislation.govt.nz/act/public/2002/0033/51.0/
DLM149789.html (accessed 2019-07-30)[13] UNISDR. Hyogo Framework for Action 2005-2015.
2005. https://www.unisdr.org/2005/wcdr/intergover/official-doc/L-docs/Hyogo-framework-for-action-english.
pdf ( accessed 2019-07-30)[14] New Zealand Ministry of Civil Defence and Emergency
Management. National Civil Defence Emergency Management Plan. 2015. https://www.civildefence.govt.
nz/cdem-sector/plans-and-strategies/national-civil-defence-emergency-management-plan/ (accessed 201907-28)[15] New Zealand Ministry of Health. National Health
Emergency Plan: A framework for Health and Disability Sector. 2015. https://www.health.govt.nz/
publication/national-health-emergency-plan-framework-health-and-disability-sector (accessed 2019-07-

340

27)
[16] Japanese Red Cross Society. History. http://www.jrc.
or.jp/english/about/history/ (accessed 2019-07-29)[17] Secretariat office of Disaster Medical Assistance Team.
DMAT to ha. http://www.dmat.jp/DMAT.html (accessed
2019-07-29) (in Japanese)
厚生労働省DMAT事務局．DMATとは．http://www.
dmat.jp/DMAT.html (accessed 2019-07-29)[18] Ministry of Health, Labor, and Welfare. Saigai-haken-seishin-iryou-team (DPAT) katsudo youryou nit
suite. https://www.mhlw.go.jp/seisakunitsuite/bunya/hukushi_kaigo/shougaishahukushi/kokoro/ptsd/
dpat_130410.html (accessed 2019-07-29) (in Japanese)
厚 生 労働 省． 災害 派 遣精 神 医 療チ ー ム（DPAT）
活 動 要 領．https://www.mhlw.go.jp/seisakunitsuite/bunya/hukushi_kaigo/shougaishahukushi/kokoro/ptsd/
dpat_130410.html (accessed 2019-07-29)[19] Ministry of Health, Labor, and Welfare. Saigaiji kenkoukiki kanri shien team nit suite. https://www.mhlw.go.jp/
file/05-Shingikai-10901000-Kenkoukyoku-Soumuka/0000131931.pdf (accessed 2019-07-29) (in Japanese)
厚生労働省．災害時健康危機管理支援チームについて．https://www.mhlw.go.jp/file/05-Shingikai-10901000-Kenkoukyoku-Soumuka/0000131931.pdf (accessed
2019-07-29)[20] Ishii M. Over view of Japan Medical Association Team(JMAT) for Disaster Relief. Japan Medical Association
Journal. 2013;56(1):1-9.
[21] Kondo H. Activity of Kumamoto Pred. coordination
office for MAT and EMT. Japanese Journal of Disaster
Medicine. 2017;21(3):446.
[22] Namikawa K, Tomita S, Ishii Y. Zairyu-gaikokujin wo
taisho ni shita bosai manual sakusei ni muketa kadai.
Journal of Japanese Society of Travel and Health.
2014;8:9-13. (in Japanese)
波川京子，富田早苗，石井陽子．在留外国人を対象にした防災マニュアル作成に向けた課題．日本渡航医学会誌．2014;8(1):9-13.
[23] Nursing Council of New Zealand. Guidelines for Cultural Safety, the Treaty of Waitangi and Maori Health inNursing Education and Practice.2011.
[24] McFarland MR, Wehbe-Alamah HM. LeiningerʼsTranscultural Nursing: Concepts, Theories, Research& Practice, 4th Edition. New York, USA: McGraw-Hill
Education; 2018.
[25] Davidhizar E, Giger JN. Transcultural Nursing 5th edition. Maryland Heights, USA: Mosby; 2007.
[26] Purnell LD. Guide to Culturally Competent HealthCare 3rd Ed. Philadelphia, US: F.A. Davis Company;
2014.
[27] Kai Y, Andou T, Kiyomura N. A survey on the current

J. Natl. Inst. Public Health, 68 (4) : 2019

Providing culturally safe nursing care in disaster: Japanese and New Zealand perspectives
status of special consideration for religion in Japanesenursing. Japanese Journal of Nursing and Health Sciences. 2019;17:22-27. (in Japanese)
甲斐ゆりあ，安藤敬子，清村紀子．日本の看護ケア
における宗教的配慮の現状に関する実態調査．看護2019;17(1):22-27.
科学研究．
[28] Kunii O, Kazuo Nomiyama. Present status of medical care for foreginers in Tochigi prefecture, Japan(2) Illness behavior of foreign workers. Jpn. J. Hyg.
1993;48:685-691. (in Japanese)
国井修，野見山一生．外国人の医療に関する研究．
日本衛生学雑誌．1993;48:685-691.
[29] Osegawa M, Morio H, Nomoto K, Nishizawa M, Sadahiro T. Present medical practice and problems in emergency disease in foreign travelers requiring hospital
admission. Journal of Japanese Association for Acute
Medicine. 2002;13(11):703-710. (in Japanese)
尾世川正明，森尾比呂志，野本和宏，西澤正彦，貞広智仁．入院を必要とした外国人旅行者の救急疾患に対する医療の現状と問題点．日本救急医学会雑誌．
2002;13(11):703-710.
[30] Hirano OH. Physical and mental health of foreign residents in Japan: A health science and nursing perspective. Fukuoka Acta Medica. 2003;94(8):241-249.
[31] Matsuo H, Kitamoto K, Inoue K, Yamada Y. Rokko Island ni okeru gaikokujin-shouni-kyuukyuuiyou no genjo to kadai. Journal of Pediatric Practice.
2004;67(10):1731-1735. (in Japanese)
松尾博哉，北本佳文，井上桂子．小児科診療．2004;
10(159):1731-1735.
[32] Wellington Region Emergency Management Office.
Community Resilience Strategy, Second Edition, Building Capacity – Increasing Connectedness – Fostering
Cooperation, September. 2014.
[33] Mori M, Sagala S, McDermott, Wulandari Y. Sinabungvolcano: how culture shapes community resilience. Disaster Prevention and Management. 2019. doi: 10.1108/
DPM-05-2018-0160[34] UNDRR. Sendai Framework for Disaster Risk Reduction 2015-2030. 2015. https://www.unisdr.org/we/
inform/publications/43291 (accessed 2019-07-29)[35] Maldonado J. Considering Culture in Disaster Practice.
2016. Annals of Anthropological Practice. https://doi.
org/10.1111/napa.12087[36] Krüger F, Bankoff G, Cannon T, Schipper E, Lisa F. Exploring the links between cultures and disasters. Krüger
F, Bankoff G, Cannon T, Orlowski B, Schipper E, Lisa
F, Eds. Cultures and Disasters: Understanding Cultural
Framing in Disaster Risk Reduction. New York: Routledge; 2015. p.1-16.
[37] Potter S, Becker J, Johnston D, Rossiter K. An overview
of the impacts of the 2010-2011 Canterbury earthquakes. International Journal of Disaster Risk Reduction. 2015. 105. 10.1016/j.ijdrr.2015.01.014.
[38] Canterbury Earthquake Recovery Authority CERA.
Funding the Recovery: The CERA Perspective. 2016.
http://www.eqrecoverylearning.org/assets/downloads/
RES0004-funding-the-recovery-the-cera-perspectivefinal.pdf (accessed 2019-07-28)[39] Phibbs S, Kenney C, Solomon M, Ngā M. an analysisof Māori responses to the C38istchurch earthquakes.
New Zealand Journal of Social Sciences Online.
2015;10(2):72-82. http://dx.doi.org/10.1080/117708
3X.2015.1066401 (accessed 2019-07-28)[40] Kako M, Ranse J, Yamamoto A, Arbon P. What was therole of nurses during the 2011 Great East Earthquakeof Japan? An integrative review of the Japanese literature. Prehospital and Disaster Medicine. 2014;29:275279. doi:10.1017/S1049023X14000405.
[41] Scott J Importance of Cultural Competency in Disaster
Management. Concept paper for Consensus Building
Meeting for the Cultural Competence for Disaster Preparedness and Crisis Response (CCDPCR). 2007.
[42] Foster M, Hirata T. A study on the stress and coping
behavior of foreign residents after the Great East Japan
Disaster (2): Relationships between social characteristics of residents and stress. Hachinohe Gakuin Daigaku
Kiyou. 2013;47:49-64.
[43] Kanbara s, Ymamoto Y, Sugishita T, Nakasa t, Moriguchi I. Japanese experience of evolving nursesʼ roles
in changing social contexts. International Nursing Review. 2017;64:181-186.

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Lev Zhuravsky, Nahoko Harada＜総説＞
文化的に安全な災害看護の提供：日本とニュージーランドの視点から
Lev Zhuravsky 1），原田奈穂子 2）
1）

Lazer Consulting. Auckland, New Zealand2）

宮崎大学医学部看護学科地域・精神看護学講座

抄録
本稿の目的は，災害対策と対応に関して文化的な方法の概念を，日本とニュージーランドの 2 大自然災害を例示して，紹介することである．
また，本稿では，両国で積み重ねられてきた経験から，全国的または地方の災害対策の構造の概要を提供する．
つづいて，文化的に安全なことの概念を，2011年の日本およびニュージーランドの地震での文化に即した災害対応の展開において紹介する．
本稿はまた，文化に即した災害対応とコミュニティレジリエンスの関連を展開する．
キーワード：災害, 看護, レジリエンス, 地域, 文化的安全

342

J. Natl. Inst. Public Health, 68 (4) : 2019